|
https://upload.orthobullets.com/topic/12102/images/p9780071819657-fi009_f025.jpg
https://upload.orthobullets.com/topic/12102/images/43d577137344a1ff3201bacbd3d361_jumbo.jpg
Introduction
  • Subaxial cervical fracture pattern caused by forced extension of the neck with resulting avulsion of the anteroinferior corner of the vertebral body
  • Pathophysiology
    • extension mechanism causes disruption of the anterior longitudinal ligament (ALL)
    • represents a true avulsion often of an anterior osteophyte
      • distinguish from a flexion teardrop fracture
        • larger fragment produced by compression
    • extension teardrop fractures are stable in flexion, and unstable in extension
      • not considered as severe as flexion teardrop fractures
  • Epidemiology
    • incidence
      • rare
  • Associated conditions
    • central cord syndrome 
      • buckling of the ligamentum flavum into canal during hyperextension phase of injury
      • risk factors
        • elderly
          • anterior osteophytes and posterior infolded ligamentum flavum
    • can be seen in diving accidents
    • not usually associated with spinal cord injuries
Presentation
  • Symptoms
    • neck pain
  • Physical exam
    • patients are usually neurologically intact
    • may have symptoms of central cord syndrome 
Imaging 
  • Radiographs 
    • recommend views
      • AP and lateral of cervical spine
    • findings
      • avulsion fracture from attachment of the ALL to the inferior corner of the vertebral body 
        • usually a thin fracture fragment
        • fragment is usually triangular in shape - reminiscent of a teardrop
        • may see anterior disc space widening
  • MRI
    • may help distinguish extension injury from flexion injury
    • edema will be located anteriorly in extension injury
Treatment
  • Nonoperative
    • immobilization in hard collar
      • indications
        • most injuries
 

Please rate topic.

Average 2.3 of 4 Ratings

Topic COMMENTS (0)
Private Note